Provider Demographics
NPI:1457589962
Name:ELITE ORTHOPEDICS AND SPINE
Entity Type:Organization
Organization Name:ELITE ORTHOPEDICS AND SPINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:F
Authorized Official - Last Name:BERKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-877-0600
Mailing Address - Street 1:2100 WEST LOOP SOUTH
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027
Mailing Address - Country:US
Mailing Address - Phone:713-877-0600
Mailing Address - Fax:713-877-0602
Practice Address - Street 1:5420 WEST LOOP SOUTH
Practice Address - Street 2:SUITE 4100
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-877-0600
Practice Address - Fax:713-877-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207X00000X, 207XS0106X, 207XS0117X, 207XX0004X, 207XX0005X, 2081P2900X, 2083S0010X, 208600000X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty